New Perspectives on the Role of Liquid Biopsy in Bladder Cancer: Applicability to Precision Medicine.

Bladder cancer (BC) is one of the most common tumors in the world. Cystoscopy and tissue biopsy are the standard methods in screening and early diagnosis of suspicious bladder lesions. However, they are invasive procedures that may cause pain and infectious complications. Considering the limitations of both procedures, and the recurrence and resistance to BC treatment, it is necessary to develop a new non-invasive methodology for early diagnosis and multiple evaluations in patients under follow-up for bladder cancer. In recent years, liquid biopsy has proven to be a very useful diagnostic tool for the detection of tumor biomarkers. This non-invasive technique makes it possible to analyze single tumor components released into the peripheral circulation and to monitor tumor progression. Numerous biomarkers are being studied and interesting clinical applications for these in BC are being presented, with promising results in early diagnosis, detection of microscopic disease, and prediction of recurrence and response to treatment.

[V grade renal trauma in patient with union pyeloureteral stenosis not known.] / Traumatismo renal grado v en paciente con estenosis de la unión pieloureteral no conocida.

Paciente de 40 años de edad, sin alergias medicamentosas conocidas y sin antecedentesde interés, que es traído a Urgencias por dispositivo de cuidados críticos por politraumatismo tras accidente de moto...

Paciente de 40 años de edad, sin alergias medicamentosas conocidas y sin antecedentesde interés, que es traído a Urgencias por dispositivo de cuidados críticos por politraumatismo tras accidente de moto...

Traumatismo renal grado v en paciente con estenosis de la unión pieloureteral no conocida / V grade renal trauma in patient with union pyeloureteral stenosis not known

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Traumatismo renal grado IV parenquimatoso con ruptura de la vía y urinoma secundario. Manejo conservador / Renal injury grade IV: Laceration and secondary urinoma. Conservative management

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[Testicular epidermoid cyst: A rare entity]. / QUISTE EPIDERMOIDE TESTICULAR: UNA RARA ENTIDAD CLÍNICA.

OBJECTIVE: Testicular epidermoid cyst is a rare clinical entity that accounts for 1% of testicular neoplasias. METHODS AND RESULTS: We report two cases of testicular epidermoid cysts in a 18 and 19 year old males with a painless testicular lesion. Testicular US was carried out showing a hypoechoic nodule in both cases. With the suspicion of testicular neoplasm inguinal orchiectomy was carried out with placement of testicular prostheses in the same act. The pathology report was testicular epidermoid cyst in both cases. CONCLUSIONS: Testicular epidermoid cysts are an uncommon benign entity. When there is a suspicion of this diagnosis, based on tumor markers and ultrasound or MRI images, testicular parenchyma-sparing surgery must be attempted.

Metástasis testicular de melanoma. A propósito de un caso / Metastatic testicular melanoma. Case report

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Pseudohernia inguinal ascendente por quiste gigante de epidídimo: diagnóstico ecográfico / Ascending inguinal pseudohernia secondary to a giant epididymal cyst: ultrasonographic diagnosis

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Hemangioma del glande de pene / Hemangioma of the glans penis

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Spontaneous hemoperitoneum secondary to retroperitoneal tumor rupture.

OBJECTIVE: To report a case of GIST type retroperitoneal tumor with spontaneous rupture to the abdominal cavity causing acute abdomen secondary to hemoperitoneum. METHODS/RESULTS: We report the case of an 84 year-old man with history of BPH and chronic atrial fibrillation. He presented to the Emergency Department with diffuse abdominal pain, syncope and accompanying vegetative symptoms. Diagnostic work up showed a 19 cm retroperitoneal mass dependent of the left kidney with active bleeding and secondary hemoperitoneum. Left radical nephrectomy was performed with pathology report of gastrointestinal stromal tumor attached to the renal capsule. CONCLUSIONS: Spontaneous hemoperitoneum is a rare entity and it has various etiologies. It is rarely described in retroperitoneal tumors.

Hemoperitoneo espontáneo por rotura de tumor retroperitoneal / Spontaneous hemoperitoneum secondary to retroperitoneal tumor rupture

OBJETIVO: Describimos un caso de tumor retroperitoneal tipo GIST con rotura espontánea a cavidad abdominal, ocasionando un cuadro de abdomen agudo secundario a hemoperitoneo. MÉTODO Y RESULTADOS: Varón de 84 años que acude a servicio de Urgencias de nuestro hospital por cuadro sincopal, con dolor abdominal difuso y cortejo vegetativo acompañante. Tras la realización de diferentes pruebas complementarias se objetiva una masa retroperitoneal de pendiente de riñón izquierdo de unos 19 cm con sangrado activo y hemoperitoneo secundario, por lo que se realiza una nefrectomía radical izquierda con resultado anatomopatológico de tumor estromal gastrointestinal dependiente de la capsula renal. CONCLUSIONES: El hemoperitoneo espontáneo es una entidad poco frecuente y de una etiología variada estando descrita en muy raras ocasiones en tumores retroperitoneales

OBJECTIVE: To report a case of GIST type retroperitoneal tumor with spontaneous rupture to the abdominal cavity causing acute abdomen secondary to hemoperitoneum. METHODS/RESULTS: We report the case of an 84 year-old man with history of BPH and chronic atrial fibrillation. He presented to the Emergency Department with diffuse abdominal pain, syncope and accompanying vegetative symptoms. Diagnostic work up showed a 19 cm retroperitoneal mass dependent of the left kidney with active bleeding and secondary hemoperitoneum. Left radical nephrectomy was performed with pathology report of gastrointestinal stromal tumor attached to the renal capsule. CONCLUSIONS: Spontaneous hemoperitoneum is a rare entity and it has various etiologies. It is rarely described in retroperitoneal tumors

Hematoma subcapsular de 13 cm en paciente con aneurisma aorta toraco-abdominal de 10 cm y trombo mural / Thirteen centimeter subcapsular haematoma in a patient with thoracoabdominal aortic aneurysm and mural thrombus

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Urogenital sinus cyst in a 21-year-old man.

We report a case of a rare congenital malformation, a urogenital sinus cyst in a young patient with non-specific symptoms for several months. A 21-year-old male presented with vague and intermittent abdominal pain. Ultrasound scan showed a retrovesical hypoechoic collection (approximately 6 cm) and left renal agenesis, compatible with a possible congenital malformation. These findings were confirmed by MRI. A laparoscopic excision of the cyst was performed with no complications. Pathology report confirmed a urogenital sinus cyst. The postoperative recovery was uneventful and the patient was discharged within 48 h. Urogenital sinus cysts are rare entities with few cases described in the literature. Imaging techniques such as ultrasound, CT or MRI may help with diagnosis. Therapeutic modalities range from observation to needle aspiration or surgical removal. In our case, we chose a laparoscopic approach to minimize morbidity and achieve an early recovery.

Estudio clínico-radiológico de tres casos de linfomas testiculares de curso agresivo / Clinical and radiological study of three cases of aggressive course testicular lymphomas

OBJETIVO: Describir las características clínico-radiológicas y las pruebas de imagen en el diagnóstico y extensión/seguimiento del linfoma testicular (LT).MÉTODOS: Se realizó ecografía-doppler color testicular, inguinal, estadiaje con Tomografía Computarizada Multidetector (TCMD); y ecografía-doppler y TCMD en una metástasis cutánea.RESULTADOS: Caso 1: Paciente de 65 años con LT hace 11 años, recidiva en el testículo contralateral 5 años después, metástasis orbitaria a los 8 años y actualmente recidiva con infiltración del nervio cubital. Caso 2: Paciente de 44 años con LT y adenopatías inguinales metastásicas. Caso 3: Paciente de 85 años con LT, adenopatías retroperitoneales y uropatía obstructiva.Histología: LNH difuso B.CONCLUSIONES: El LT suele cursar de forma agresiva, con afectación testicular contralateral, extensión extratesticular o a distancia. Las principales técnicas radiológicas son la ecografía-doppler para el estudio de la enfermedad primaria y el TCMD en la extensión. El diagnóstico es histológico y el tratamiento quirúrgico asociado a radioterapia o quimioterapia, siendo el pronóstico malo(AU)

OBJECTIVE: To describe the clinical and radiological features, and the role of imaging in diagnosis and extension study of testicular lymphoma (TL).METHODS: Testicular and inguinal color Doppler ultrasound, extension-study Multidetector Computed Tomography (MDCT), and Doppler ultrasound and MDCT in an upper extermity metastasis were performed.RESULTS: Case 1: A 65-year-old man with TL 11 years ago, recurrence in the contralateral testis 5 years later, orbital involvement at 8 years and currently recurrence in the arm with ulnar nerve infiltration. Case 2: A 44-year-old man with TL and metastatic inguinal lymphadenopathy. Case 3: An 85 year-old man with TL, retroperitoneal lymph nodes and obstructive uropathy. Histological subtype: B-cell non-Hodgkin´s lymphoma.CONCLUSIONS: TL typically presents as an aggressive disease with contralateral testicular involvement and spreading to regional lymph nodes and non-contiguous extranodal sites. The main radiological techniques are Doppler ultrasound for the study of the primary disease and MDCT in the evaluation of disease extension. Diagnosis is usually obtained after orchiectomy by histological study, and despite the aggressive treatment modalities (surgery associated with radiotherapy or chemotherapy) prognosis remains poor(AU)